But, the language in the DSM-II and the subsequent link between insanity and the civil rights movement, was not limited to institutionalized patients. Dr. Metzl also discovered trends in the culture at large.
He explains in his book that the stigma describing schizophrenia as a hostile and violent disorder was found in medical journals, newspapers, magazines, films, and more. He even describes a pharmaceutical advertisement for anti-psychotic medications depicting images of an angry, hostile Black male.
Schizophrenia Diagnosis Blacks Today
To diagnose schizophrenia, clinicians must first rule out other potential causes of symptoms. In a recent, 2019 Science News article, Michael Gara, Professor of Psychiatry at Rutgers Robert Wood Johnson Medical School stated, “There has been a tendency for clinicians to overemphasize the relevance of psychotic symptoms and overlook symptoms of major depression in Blacks compared with other racial or ethnic groups.
A 2019 study looked at nearly 600 Blacks and 1,058 Caucasians.
This study concluded that clinicians diagnosing mental health disorders put more emphasis on the psychotic symptoms than on depression or mania when assessing minority groups (even when the symptoms were very similar to those exhibited in Caucasians who were not diagnosed with schizophrenia. This study suggests a racial bias in diagnosing schizophrenia in Blacks.
Consequences of Misdiagnoses in Blacks
Misdiagnoses of schizophrenia can result in severe consequences for patients who may actually have major depression with psychotic features or psychotic disorders; the treatment is very different for these two disorders. Misdiagnosis can result in consequences such as:
- Not receiving proper medication
- Risking worsening of the underlying symptoms
- Risk of suicide (from untreated depression)
- Serious side effects from antipsychotic medications (for schizophrenia)
A Word From Black Doctor.org
If you or a loved one has been diagnosed with schizophrenia, or are scheduled for an upcoming mental health assessment, you may consider letting the diagnostician know that some researchers suggest screening for major depression when evaluating Black patients for schizophrenia.